Treatment
Treatment may include antibiotic therapy, hot compresses and application of depilatory creams.
In more severe cases, the cyst may need to be lanced or surgically excised (along with pilonidal sinus tracts). Post-surgical wound packing may be necessary, and packing typically must be replaced twice daily for 4 to 8 weeks. In some cases, two years may be required for complete granulation to occur. Sometimes the cyst is resolved via surgical marsupialization.
Surgeons can also excise the sinus and repair with a reconstructive flap technique, which is done under general anesthetic. This approach is mainly used for complicated or recurring pilonidal disease, leaves little scar tissue and flattens the region between the buttocks, reducing the risk of recurrence.
A novel and less destructive treatment is scraping the tract out and filling it with fibrin glue. This has the advantage of causing much less pain than traditional surgical treatments and allowing return to normal activities after 1–2 days in most cases.
Pilonidal cysts recur and do so more frequently if the surgical wound is sutured in the midline, as opposed to away from the midline, which obliterates the natal cleft and removes the focus of shearing stress.
Read more about this topic: Pilonidal Cyst
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